NPI | 1881336683 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: RI APRN03116) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: RI 00000) |
Enumeration Date | 2022-04-12 |
Last Update Date | 2022-06-02 |